Evidence map›Paper›PMID 36494829›Full record

ArticleBMC health services research2022

Comparing mental and physical health of U.S. veterans by VA healthcare use: implications for generalizability of research in the VA electronic health records.

David S Fink, Malka Stohl, Zachary L Mannes, Dvora Shmulewitz, Melanie Wall, Sarah Gutkind, Mark Olfson, Jaimie Gradus, Salomeh Keyhani, Charles Maynard and 5 more

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
10.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 38 citations in OpenAlex.

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  10. Cannabis Use Among Older Adults.JAMA network open · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 1 country.

David S FinkNew York State Psychiatric Institute, New York, NY, USA.
Malka StohlNew York State Psychiatric Institute, New York, NY, USA.
Zachary L MannesColumbia University Mailman School of Public Health, New York, NY, USA.
Dvora ShmulewitzNew York State Psychiatric Institute, New York, NY, USA.
Melanie WallNew York State Psychiatric Institute, New York, NY, USA.
Sarah GutkindColumbia University Mailman School of Public Health, New York, NY, USA.
Mark OlfsonNew York State Psychiatric Institute, New York, NY, USA.
Jaimie GradusBoston University School of Public Health, Boston, MA, USA.
Salomeh KeyhaniVeteran Affairs, San Francisco, VA, USA.
Charles MaynardVeteran Affairs, Puget Sound Health Care System, Seattle, WA, USA.
Katherine M KeyesColumbia University Mailman School of Public Health, New York, NY, USA.
Scott ShermanNew York University, New York, NY, USA.
Silvia MartinsColumbia University Mailman School of Public Health, New York, NY, USA.
Andrew J SaxonVeteran Affairs, Puget Sound Health Care System, Seattle, WA, USA.
Deborah S HasinNew York State Psychiatric Institute, New York, NY, USA. deborah.hasin@gmail.com.
Columbia University · USNew York Psychoanalytic Society and Institute · USNew York State Psychiatric InstituteBoston University · USNew York University · USUniversity of California, San Francisco · USUniversity of Washington · USVA Puget Sound Health Care System · US

Funding

Substance Abuse Epidemiology Training Program (SAETP) at Columbia UniversityT32DA031099 · NIDA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI DEBORAH S HASIN, Silvia Saboia Martins · 2012 to 2026
$6.1M
Impact of Medical and Recreational Marijuana Laws On Cannabis, Opioids And Psychiatric Medications: National Study of VA Patients, 2000 - 2024R01DA048860 · NIDA · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI HASIN, DEBORAH S · 2019 to 2023
$4.1M
New York State Psychiatric Institute N/ANIDA NIH HHS R01 DA048860NIDA NIH HHS R01DA048860NIDA NIH HHS T32 DA031099
6 · The paper itself

Abstract

objectiveThe Department of Veterans Affairs' (VA) electronic health records (EHR) offer a rich source of big data to study medical and health care questions, but patient eligibility and preferences may limit generalizability of findings. We therefore examined the representativeness of VA veterans by comparing veterans using VA healthcare services to those who do not.

methodsWe analyzed data on 3051 veteran participants age ≥ 18 years in the 2019 National Health Interview Survey. Weighted logistic regression was used to model participant characteristics, health conditions, pain, and self-reported health by past year VA healthcare use and generate predicted marginal prevalences, which were used to calculate Cohen's d of group differences in absolute risk by past-year VA healthcare use.

resultsAmong veterans, 30.4% had past-year VA healthcare use. Veterans with lower income and members of racial/ethnic minority groups were more likely to report past-year VA healthcare use. Health conditions overrepresented in past-year VA healthcare users included chronic medical conditions (80.6% vs. 69.4%, d = 0.36), pain (78.9% vs. 65.9%; d = 0.35), mental distress (11.6% vs. 5.9%; d = 0.47), anxiety (10.8% vs. 4.1%; d = 0.67), and fair/poor self-reported health (27.9% vs. 18.0%; d = 0.40).

conclusionsHeterogeneity in veteran sociodemographic and health characteristics was observed by past-year VA healthcare use. Researchers working with VA EHR data should consider how the patient selection process may relate to the exposures and outcomes under study. Statistical reweighting may be needed to generalize risk estimates from the VA EHR data to the overall veteran population.

Indexed as

United States Department of Veterans AffairsVeteransAdolescentElectronic Health RecordsEthnicityHealth Services AccessibilityHumansMinority GroupsPainUnited StatesBig dataElectronic health recordsGeneralizabilityUnited States Department of Veterans AffairsVeterans health

Identifiers

PMID36494829
PMCPMC9733218
OpenAlexW4311665057

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.